Patient/(Student) Doctor Interaction

Aside from our traditional science classes, one of the classes we're just now starting up is "Essentials of Clinical Medicine." It's actually a pretty cool "class." Minus the required attendance, that is. Boo to that. Anyway, class in quotes because it's not one in the traditional sense of lectures and labs. There are still lectures with all ~200 of us, but they aren't as hardcore as the other science ones we have. These lectures cover somewhat interesting topics. Today's was "cultural competency and health literacy," both legitimate concerns in a city like Chicago. Looking ahead, stuff like stress in medicine, teamwork, leadership, professionalism, and patient safety are also covered. Yeah I know, I said they were *somewhat* interesting. They're good things to cover, especially since everyone lacks in one or more department. Thing is, I don't think that you can really teach people these things. It's a nice idea though, and I like that they're trying to help develop professional skills.

Another aspect of ECM is that of small groups, in which we're divided into set groups of about 12 for the entire year, with M3s and M4s leading our groups. We touch on some of the stuff covered in lectures, but with more emphasis on clinical aspects. M1 year's small group emphasis is mostly on history taking and patient interviewing. Throughout the year we'll have our groups meet to talk/learn about different aspects of history taking and the patient interview. And the nice thing is that we actually get to head out to different hospitals to work on our this stuff, in addition to "learning" about it.

Along with the small group history and interview stuff, there's more clinical stuff. And I'll be honest, I'm a fan of clinical stuff. There's a few classes on taking vital signs. And even better, we get paired up with a Chicagoland primary care doctor and end up shadowing him/her throughout the year. From what I've heard, some of the cooler docs give some of their students quite a bit of latitude in clinic.

To those out there, you might be thinking "big whoop." Clinical stuff. I thought that's what med school was about. Actually for the first two years, a lot of med schools have little clinical stuff outside of extracurricular organizations (if even that). At these places it's straight up books for two years, first part of boards, and then straight into clinical rotations. I like what UIC is doing with ECM, giving us clinical experience within the M1/M2 curriculum - in addition to the numerous extracurricular opportunities. I especially like that they try and prep us for clinical rotations by teaching clinical skills the first two years (history taking M1 year, physical exam M2 year) in addition to giving us a lot of patient and doctor interactions. Again, a lot of schools don't do this. This is actually one reason that I picked UIC - they're known for producing clinically ready docs.

ECM started up last week and we got to interview our first patients as med students. I'd had decent exposure to this sort of patient interaction from my clinic job. Still, it was nice to dress up as a pseudo-doctor (white coat and all) get to actually get to talk to patients - especially for those who haven't done this sort of thing before. There was no real structure to the session - a resident and a (real) patient were up on stage and had a real medical interview for all of us to observe. We then broke down into groups, each complete with a patient to interview. It was a weird dynamic having six students interviewing one patient, but it worked out pretty well in my group. IMO, the idea of the session was to get us used to talking to patients and get us a rough idea of the types of questions to ask - because not everyone has this type of exposure. It was kinda cool seeing how different people interact with patients. Every group interviewed two patients and pretty much everyone had good things to say about the session. Our group was pretty lucky in that our patients were sociable and very unabashed in talking to six random kids about their medical problems. Both patients said they'd gladly have us as doctors. Sure I'm tooting my own horn there, but it's nice to hear that sort of thing amid all the studying.

Anyway, I head out to another free clinic this Saturday - this time up on the north side. I'm pretty excited about it, especially after my last free clinic experience. And the nice thing is that these free clinics are all through extracurricular organizations. UIC's students are amazingly good at organizing stuff like this and coordinating with other organizations/schools. I can't claim to help out, but I'm glad that these opportunities are out there. Aside from that, ECM is set to get going: vital signs, history taking, and finding out who our preceptor (shadowing doctor) all within the next few weeks. Now, if I didn't have a physio, histo, and biochem/nutrition exam all within a seven day period, things would be that much better. Ah well, comes with the territory I suppose.

A Day in the Life

For those that know me, you know that I went to the vast majority of my classes in undergrad. Enter med school, and not so much anymore. Labs and one lecture are the only things that bring me to the building called UIC COM. What do I do with all that extra time? Well, here's a rough idea of how this past week went down.

Our schedule changes every day and week. As a general rule though, we're supposed to start around 9:15 and finish up with lectures/labs sometime between 4:30-5:30. Anatomy lab has a nasty habit of running over, with some groups having to stay past 7:00. Anatomy days are always long days regardless. The professor likes talking over his allotted time by anywhere from 30-60 minutes...making it hard for me to judge when to show up to lab. And then lab. Fat cadavers: no fun. Cadaver anatomy not looking like pictures: no fun. Summation: long dissections.

You might notice that there's a lot of "study" going on during the day. Instead of lecture, that's what I'm up to. That's my attempting to catch up with classes. This endeavor meets with limited success. I only truly catch up if a class has an exam coming up. Anyway, some of that study the past week was working on this morning's 30 lecture biochem exam worth 45% of my grade. Even our usually chill study group was freaking out a little bit. Thirty lectures in less than a month is a bit intense for my liking. Especially when I hate biochem. Some of that study was also because I did absolutely nothing productive the weekend of 10/5 since my parents were visiting. Unless you count being out in Lincoln Park and downtown as productivity. And if productivity means awkwardtivity when coming in at 3:00 to my parents sleeping.

Either way though, after today's exam, I'm done with most of biochem. Seventy lectures in eight weeks. And I pretty much despised all of them. Hence, no ordinary post-exam drinking occasion. Tonight's drinkage will be happening down in Chambana.

And now, I'm off to sleep. And very well I might add.

Wow!

I've mentioned how much studying goes on for me now and how much it sucks. Today: 9-1230 downtown library, 130-630 anatomy lecture/lab, 830-12 more studying. Some of it is just of no interest to me (biochem, histology). And for that reason, I haven't been to those lectures since the first week. That, and I get more done on my own for those classes (e.g. why I was in the library from 9-1230).

Overall though, I find anatomy and physiology interesting. They're just a lot more applicable to what we'll eventually be doing. For both these reasons, it's somewhat easier and more enjoyable to study that stuff. This morning, I switched from anatomy (heart) to biochem (nitrogen metabolism) and it was painful. I just don't really care how or why certain amino acids get degraded. And the pathways. Way too many pathways. Not a fan of them - especially when they all start interacting with each other.

But getting back to the title of the post. I was catching up on heart readings this morning because we were going to dissect the lungs and heart in anatomy lab later in the day. Come 430, we took the heart out of our cadaver and were cutting into it. The feeling when I cut into the heart was one of awe. I was holding a human heart in my hands. To think that this heart was beating and keeping someone alive was amazing. This thing pumped ~70 times a minute for 75 years. Getting back to the dissection - seeing the inside of the heart and how everything relates and works together was, in the very sense of the word, awesome. Easily the highlight of med school so far (along with clinic). The muscular wall of the heart is a lot thicker than I thought it was going to be. Seeing the different structures, valves, vasculature - again awesome. Looking at/through the lungs was a similar experience - again thinking that I held the very organs that let this woman breathe. And once we took out both lungs, the diaphragm is sitting right there. The muscle that lets us breathe. Again, it contracted ~16 times/minute for 75 years. It's a lot bigger and thicker than I had imagined it.

Sure, we've been having anatomy lab for a while. But up until last week we'd been working on back and chest muscles. It wasn't until last week and today that we got to look at and dissect some of the major organs. And it was ridiculously exciting being able to see, touch, and cut into the same organs that we've heard about since grade school. A lot better than looking at rhomboid muscles in the back.

It was today that I realized it's a privilege being able to study anatomy on preserved cadavers. The fact that we get to dissect a human body from skin down to organs is something most people don't get to do. AKA - not everyone gets to hold a human heart, much less poke around inside it. With this realization, came an appreciation for those who donate their bodies to science and afford me this opportunity.

Having said that, a random note about obesity. Don't do it. Our cadaver is definitely obese. Makes finding and identifying things so much harder. Also, cutting through fat is not fun. Especially when it's three finger-widths thick in places. Oh, and when you're that big, fat is everywhere. Below the skin, around organs, fused to the heart. But like I said - I definitely appreciate the learning opportunities that our woman gives us.

It's nice to have days like this, getting to look at hearts and whatnot. Feeling excitement amid all the studying. Reminding us that there's cool stuff in medicine. AKA anatomy and physiology. Not histology. Not biochem.